Tag Archives: University of Washington

HIV Could Spread If Birth Control Injections Increase, Warn Scientists

Researchers call for new guidelines for women using family planning services in Aids-hit areas.  Campaigns to increase the number of women opting for long-lasting contraceptive injections in Aids-hit parts of the developing world could be helping to spread the epidemic, scientists are warning.

New research shows that women who use hormonal contraceptives may double their risk of contracting HIV and of passing it to their male partner, throwing up a new dilemma for global development.

The authors of the large-scale study, published in the journal Lancet Infectious Diseases, call for urgent guidance to be drawn up and given to women using family planning services in HIV-endemic areas. The study showed particularly that the risk of HIV transmission was raised by the long-lasting injections that are most widely used and most popular in the sub-Saharan regions worst hit by the Aids epidemic.

The results present a significant problem for global health and development. Unwanted pregnancy is a threat to a woman’s life and can lead to greater poverty and deprivation for her family. The more children she has, the harder it will be to feed and educate them.

While family planning is still resisted in parts of the developing world, campaigns to promote injectable contraception have met with some success. Many women have sought out the injections that last for months and that they can sometimes get without their husband’s knowledge if he refuses permission.

But the study of 3,800 couples shows that there is a risk which has previously been suspected but unconfirmed. The risk was present for those who took the pill too, but it was not statistically significant because most women in the study had opted for injections.

“These findings have important implications for family planning and HIV-1 prevention programmes, especially in settings with high HIV-1 prevalence”, said Jared Baeten from the University of Washington, Seattle, one of the study’s authors.

“Recommendations regarding contraceptive use, particularly emphasising the importance of dual protection with condoms and the use of non-hormonal and low-dose hormonal methods for women with or at risk for HIV-1, are urgently needed,” said lead study author Renee Heffron, also from the University of Washington.

More than 140 million women worldwide use some form of hormonal contraception.

The study group comprised 3,790 couples where one partner had HIV (usually the woman) although the other did not. They were drawn from two existing studies of HIV incidence in seven African countries – Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zimbabwe.

The researchers found that women who did not have HIV were twice as likely to be infected by their partner if they were using hormonal contraception. Those who had HIV themselves were twice as likely to give it to their partner. Tests showed that women with HIV using injectable contraception had raised concentrations of virus inside the cervix. Researchers are unclear why and a larger study specifically designed to look at this issue should be carried out, they say.

Meanwhile women should be told there may be an increased risk of HIV infection if they use hormonal contraception and should be counselled that condoms will give them dual protection.

In a comment published by the journal, Charles Morrison from Clinical Sciences, Durham, USA, said: “Active promotion of DMPA [injectable contraception] in areas with high HIV incidence could be contributing to the HIV epidemic in sub-Saharan Africa, which would be tragic. Conversely, limiting one of the most highly used effective methods of contraception in sub-Saharan Africa would probably contribute to increased maternal mortality and morbidity and more low birth weight babies and orphans—an equally tragic result. The time to provide a more definitive answer to this critical public health question is now; the donor community should support a randomised trial of hormonal contraception and HIV acquisition.”

Original Article by Sarah Boseley, health editor at The Guardian

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Gamers Crack Code That Could Lead to New AIDS Treatments

Scientists spent a decade trying—and failing—to map the structure of an enzyme that could help solve a crucial part of the AIDS puzzle. It took online gamers all of three weeks.

The enzyme in question is the Mason-Pfizer monkey virus retroviral protease, and researchers have been seeking ways of deactivating it as a way of developing new anti-HIV drugs. Unfortunately, the conventional efforts of computers and scientists have come up short for years.

Enter: Foldit. Foldit was developed in 2008 as a means of discovering the structures of various proteins and amino acids—something computers can’t do very well—by turning it into a game. By inputting the experimental coordinates for the monkey virus enzyme, gamers—most of whom didn’t have a background in molecular biology—were able to accurately predict the structure of the protein, allowing scientists to pinpoint locations to stop the virus’ growth.

The study, published in Nature Structure & Molecular Biology, details how incredible a step this is towards developing more effective therapies for HIV/AIDS patients. It’s also an important precedent that lays the groundwork for scientists and lay people to work together to solve new problems and save lives. Which is very exciting.

Original Article via Gizmodo via Sydney Morning Herald via The Next Web

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Exercise Guidelines Published for People with HIV Over 50

A combination of aerobic and resistance exercises, three times a week for at least six weeks, is recommended to improve cardiovascular, metabolic and muscle function in people living with HIV older than 50 years of age, according to suggested guidelines published ahead of print by the Journal of the Association of Nurses in AIDS Care.

A great deal has been written about the potential benefits of regular exercise, particularly for older individuals living with, or at risk for, various age-related health complications. Because people living with HIV appear to face a higher risk of certain age-related problems—notably increased rates of cardiovascular disease (CVD) and various metabolic health issues at younger ages—and may also be taking numerous medications, there has been interest in utilizing drug-free lifestyle changes to improve disease-free survival.

Anella Yahiaoui, a research assistant at the University of Washington, and her colleagues set out to develop exercise recommendations for people living with HIV, based on the quantity and quality of exercise-based research that has been conducted and published.

Much of the available HIV-specific research—12 studies were included in the analysis—focused on younger individuals and primarily demonstrated positive effects of aerobic and resistance exercise on symptoms of wasting syndrome, notably muscle size and strength. Data were limited with respect to the effects of exercise on today’s most concerning age-related health complications among people living with HIV.

Yahiaoui’s team therefore included data from studies exploring the benefits of exercise in frail HIV-negative adults over the age of 65 and HIV-negative adults over the age of 55 with metabolic syndrome—a group of risk factors, similar to those seen in HIV-positive people with lipodystrophy, that occur together and increase the risk for CVD, stroke and type 2 diabetes.

Among the HIV-negative study volunteers with metabolic syndrome, exercise was independently associated with improvements in lipid levels and markers of insulin resistance, compared with matched patients who did not exercise. Among frail patients, some studies showed benefits associated with aerobic and resistance exercise, whereas others did not.

Based on the review of published data, Yahiaoui and her colleagues were able to devise a handful of key recommendations for people living with HIV over the age of 50.  Aerobic exercise, for example, should be performed at least three times a week for 20 to 40 minutes, aiming for a heart rate between 50 and 90 percent of the maximum heart rate.

Resistance exercises—which includes weight lifting and calisthenics, such as pushups, pull-ups and sit-ups—should involve each major muscle group and be performed after an aerobic exercise has been completed, again at least three times a week. One or two sets of six to eight repetitions of each exercise, with 20 to 30 seconds between each set, is  the recommended initial goal, eventually building up to three sets of ten repetitions of each exercise as endurance and strength improves.

Stretching, before and after exercising, is also recommended to prevent injuries.

There is, however, the possibility of too much of a good thing, the authors warn.  Athletes who exercise frequently and strenuously are at an increased risk of various infections, which can potentially lead to serious health problems in people living with HIV. In turn, Yahiaoui’s group cautions, exercise should not exceed 90 minutes of strenuous activity.

“Further research is warranted to study the benefits and risks of physical exercise in older HIV-infected patients,” the authors conclude.

Original Article via Aidsmeds.com

Also see “Aging & HIV Positive: A Growing Demographic

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